Bile, Cauterization, and Exercise: Cancer Treatment Was a Very Different Story in Ancient Greece

Cancer has existed since before the dawn of civilization. By the time of the ancient Greeks, cancer as a disease was already diagnosed by physicians, along with recommendations for its treatment. But their way of understanding medicine and the human body was very different than how doctors see things today. To start with, black bile is no longer involved.

The Earliest Known Cancer Cases

The earliest known example of cancer has been found in a foot bone belonging to a hominin species from South Africa. The bone has been dated to between 1.6 and 1.8 million years ago and shows signs of an aggressive type of cancer known as osteosarcoma. The oldest written description of cancer, however, comes from ancient Egypt. In the Edwin Smith Papyrus, eight cases of tumors or ulcers of the breast are described. As the papyrus is part of a surgical treatise, the recommended treatment for this problem was the removal of the tumor by cauterization.

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The Edwin Smith papyrus, the world's oldest surviving surgical document. Written in hieratic script in ancient Egypt around 1600 B.C., the text describes anatomical observations and the examination, diagnosis, treatment, and prognosis of 48 types of medical problems in exquisite detail. Plate 6 and 7 of the papyrus, pictured here, discuss facial trauma. (Public Domain)

The word ‘cancer’ itself, however, was coined much later on, during the Classical period. The man credited with naming the disease is the Greek physician Hippocrates, who is generally considered to be the ‘Father of Western Medicine’. Hippocrates used the Greek terms carcinos (the word for crab) and carcinoma to describe non-ulcer forming and ulcer forming tumors respectively. These terms are derived from the observation that when a solid malignant tumor was cut, it had finger-like projections that spread in all directions. Moreover, the tumors were hard, like the shell of a crab. Thus, the signs of the disease brought to mind the image of a crab. The Greek term was later translated into Latin by the Roman medical writer Celsus, thus becoming ‘cancer’.

Hippocrates. (Lawrence OP/CC BY NC 2.0)

Black Bile in Excess

Hippocrates employed the humoral theory to explain the way the human body functioned. According to this theory, the human body consisted of four different types of liquids, or humors – blood, phlegm, black bile, and yellow bile. In a healthy body, all four liquids are in equilibrium. The occurrence of illnesses, therefore, is caused by imbalance in the humors.

In the case of cancer, Hippocrates and other Greek physicians believed that it was an excess in black bile that caused this deadly disease. If the spleen did not clear out this extra black bile, cancer could develop in any part of the body. Incidentally, the humoral theory was the dominant medical theory in Europe for many centuries, and exerted a major influence on medical knowledge well into the 19th century. Therefore, for many centuries to come, an excess of black bile was thought to be the culprit behind cancer.

Physician treating a patient. (Marie-Lan Nguyen/ CC BY 3.0 )

The Ancient Greek Methods for Treating Cancer

According to the humoral theory, a sickness can be cured if the balance of the four humors is restored, which may be achieved via a number of methods. Some of these treatments are relatively harmless, and include exercise, herbal medication, and a change in diet. More aggressive methods include blood-letting and purging, which potentially caused more harm than good.

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As for the treatment of cancer, the ancient Greek physicians recommended that various medical solutions and drugs be given to a patient if the cancer was in the early stages of development. If this failed to get rid of the excess black bile, the next step was to surgically remove the tumor, after which the surrounding area was cauterized, to avoid excessive hemorrhage. A diet and exercise program aimed at boosting a patient’s health after the surgery was prescribed.

Greek physician and patient, plaster cast in W.H.M.M. (Wellcome Collection/CC BY 4.0)

Still, the Classical physicians were aware that those suffering from cancer had little chance of survival. Galen, the Greek physician who lived during the Roman period, for instance, was of the opinion that there was no cure for cancer, and intervention, save the removal of the tumor at an early stage, would cause further harm to the patient.

Portrait of Galen. (Public Domain)

Top image: ‘Alexander of Macedon trusts the doctor Philip’ (1870s) by Henryk Siemiradzki. Alexander is drinking a draught prepared by his trusted physician Philip after suffering from a severe fever. Humoral theory was used to cure illnesses, from fever to cancer, in ancient Greece. Source: Public Domain

By Wu Mingren